# ST. VINCENT PHYSICIAN NETWORK LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124253901
- **Authorized official:** MR. D. BRUCE HAGA (VICE PRESIDENT)
- **Authorized official phone:** (317) 583-3079

## Contact information

- **Practice address:** 301 HENRY ST, BLDG B, NORTH VERNON, IN 47265-1030
- **Practice address phone:** (812) 352-4300
- **Mailing address:** 10330 N MERIDIAN ST, STE 300, INDIANAPOLIS, IN 46290-1024
- **Mailing address phone:** (317) 583-3079

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/21/2009
- **Last updated:** 08/31/2009